1. Wisconsin Department of Public Instruction
CONTINUING EDUCATION ACTIVITY REPORT
PI-2453 (Rev. 09-11)
INSTRUCTIONS: Complete and submit annually to your library
system validator along with the Annual Summation of Continuing
Education Activities, Form PI-2454. Refer to the Certification
Manual for Wisconsin Public Library Directors for assistance.
Name Last, First, Middle
Mailing Address Street / PO Box, City, State, ZIP
I. CONTINUING EDUCATION ACTIVITY DESCRIPTION
Title of Program
Grassroots Meeting
Description of Program
Our annual meeting will feature Elissa Ewert, Youth Services Librarian at the Beaver Dam Community Library, who will share
ideas and resources from her six years of creating fun, simple, developmentally-appropriate storytimes. Come prepared to
learn, share and participate in an interactive presentation.
Relationship of Program to Present Position or Career Advancement
Activity Dates Location Number of Contact Hours
From Mo./Day/Yr.
9/17/2015
To Mo./Day/Yr.
9/17/2015 De Pere
Technology If any
Total
3.0
Provider If applicable
NFLS
Category Check one, attach written summary if applicable
A. Credit Continuing Education Attach formal documentation from the sponsoring agency.
B. Noncredit Continuing Education
C. Self-directed Continuing Education
II. SIGNATURE
I HEREBY CERTIFY that the information provided is true and correct to the best of my knowledge.
Signature of Participant
Date Signed Mo./Day/Yr.
